Biopsy: preparation, analysis time, reviews and prices. Histological examination Methods for studying material

Every year, a million women around the world receive a terrible diagnosis at an appointment with a mammologist - breast cancer. According to statistics, every eighth woman is at risk of encountering this life-threatening disease. But there are also encouraging facts - with early detection of pathology, breast cancer is effectively treated by removing the breast, followed by correction of its shape, after which the patient returns to a full life without restrictions.

The most important issue in medicine has become the development of both a safe and informative method for diagnosing breast tumors. The method must detect cancer and at the same time clearly distinguish a malignant tumor from a cyst. A necessary component of this technique is Core biopsy.

What is the advantage of a biopsy over an ultrasound?

Ultrasound methods detect the presence of a tumor or cyst, but do not identify the neoplasm. This fact complicates treatment, because the doctor cannot objectively assess whether surgery is necessary to remove the tumor and the gland as a whole. A biopsy, including the Core method, is precisely the diagnostic measure that helps make the picture of the disease complete. During this study, the doctor receives biological material for further cytological and histological analysis in the laboratory. This, in turn, is the only way to obtain an accurate and reliable diagnosis.

How is a core biopsy performed?

The first method of performing a breast biopsy is an open technique, based on dissecting the soft tissue of the breast and gaining access to the tumor. This method is highly informative, but it is a full-fledged operation, which is unjustified if the tumor turns out to be benign.

To reduce the risk of complications and simplify the procedure, needle techniques were developed. In this case, the biopsy procedure involves taking tumor tissue through a thin needle. Such techniques are easily tolerated by patients and do not injure the breast, but they have one significant drawback - the inability to take a sufficient amount of material.

The solution to this problem was Core biopsy. The difference between this technique and other needle procedures is the use of a larger diameter needle, which has a blade at the end. As a result, during the procedure it is possible to obtain the required volume of tissue for further laboratory biopsy.

Is there a possibility of error when performing a Core biopsy?

The procedure is carried out under ultrasound control, which eliminates the possibility of error. The advancement of the needle into the depths of the soft tissue is reflected on the monitor, which allows the doctor to take a cell sample exactly in the place where the tumor is localized.

Does Core Breast Biopsy hurt?

Of course, the use of a special needle or gun, despite being minimally invasive, traumatizes tissue, and without anesthesia it would be painful. However, unlike open surgery, which is performed under general anesthesia, for Core biopsy it is enough to use local anesthesia. This significantly expands the scope of application of the diagnostic technique for patients for whom general anesthesia is contraindicated.

Will there be a scar after a Core biopsy?

One of the important advantages of this method is the absence of cosmetic damage. There are no scars or scars left on the patient’s body, which is especially important in cases where the tumor turns out to be benign and does not require removal of the mammary gland.

Can the results of a Core biopsy be trusted 100%?

Like any other diagnostic procedure, trepanobiopsy cannot guarantee a 100% reliable result; it provides the study with 98% information content and reliability, which is not inferior to a complex open method.

Are there breast tumors that cannot be examined with a core biopsy?

Core biopsy at Best Clinic

Best Clinic strives to make diagnostics as accurate and safe as possible for its patients. At the Best Clinic medical center on Krasnoselskaya, a device for collecting cell tissue samples from tumors has been installed and is in operation. Women with suspected breast cancer can confirm or deny the diagnosis today.
Make a choice in favor of Core biopsy and get a reliable examination result, which will ensure subsequent timely and effective treatment!

A biopsy is a diagnostic procedure in which a piece of tissue or organ is removed for subsequent microscopic examination. .

If cancer is suspected, a biopsy is required. since without it the diagnosis is not considered definitively established.

A biopsy is also performed for some non-oncological processes. For example, with autoimmune thyroiditis, some types of hepatitis, Crohn's disease, etc.

In this situation, it is an additional research method and is carried out when data from non-invasive diagnostic methods (CT, MRI, ultrasound, etc.) is not enough to make a diagnosis

Types of biopsy

Depending on the method of collecting material, there are the following types of biopsy:

• excisional – excision of the entire tumor or organ;
• incisional – excision of part of a tumor or organ;
• puncture – percutaneous sampling of a tissue fragment with a hollow needle.
• washes and smears.

Excisional and incisional biopsy

These types of biopsies are quite painful, so they are performed under general anesthesia or local anesthesia in an operating room (the exception is endoscope-guided biopsy), and require suturing afterward. Excisional biopsy often performed not only for diagnostic purposes, but also for treatment purposes, incisional- for diagnostic purposes only. Sometimes during surgery for cancer it is necessary to urgently perform an incisional biopsy to clarify the scope of the operation.

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Needle biopsy

A minimally invasive method is a puncture biopsy. Its principle is that a hollow needle is inserted into the pathological formation or organ that needs to be examined. Pieces of tissue through which the needle passed get into it. After the needle is removed, these areas are sent for examination. If you need to examine an organ that is located deeply (that is, it cannot be seen and “palpated”), then the puncture is done under ultrasound or X-ray control.

For greater accuracy and to reduce trauma, a biopsy can be done under the control of ultrasound, endoscope, or x-ray.

In practice, two types of puncture biopsy are used:

• fine-needle (aspiration, classic);
• thick needle (cutting, trephine biopsy).

The advantage of a puncture biopsy is that this procedure is minimally painful. It is done without general or local anesthesia.

Why is a core needle biopsy performed?

In some cases, a local anesthetic is injected into the skin puncture site. But this type of biopsy also has its disadvantages. Firstly, the needle may not penetrate the pathological formation. Secondly, the material remaining in the needle cavity may not be sufficient for examination.

These factors significantly reduce the reliability of the method. The doctor’s experience and the quality of the equipment under whose control the manipulation is performed can compensate for the first drawback. To compensate for the second, modified techniques are used, in particular, core biopsy.

Core needle biopsies use threaded needles that are screwed into tissue like a screw. In this case, tissue areas that are much larger in volume remain in the needle cavity than with a fine-needle biopsy.

Biopsy guns make the procedure much easier for both the doctor and the patient.

This is the name of the devices that are used for fine-needle aspiration biopsy of various organs: pancreas, thyroid and prostate glands, liver, kidney, etc. A sterile needle is attached to the gun, consisting of a trephine (a tube with a very sharp edge) and a harpoon.

When fired, the trephine cuts tissue with great speed, and the harpoon fixes the tissue in the tube. As a result, a large column of material ends up in the needle cavity, which is sent for microscopic examination.

Taking swabs and swabs

In fact, taking smears and swabs is not a type of biopsy, but they, like biopsies, are used to determine the type of tissue and cells. Fingerprints are taken from accessible research objects. Thus, taking smears for atypical cells is widely used in gynecology for early diagnosis of cervical cancer.

To obtain swabs, the lumen of a hollow organ is washed with saline; for example, during bronchoscopy, swabs from the bronchi can be obtained. Fluid from a cyst (for example, breast cysts if breast cancer is suspected) or any body cavity, for example, pleural effusion, ascitic fluid, etc., can also be examined for malignant cells.

Study of the obtained material

Depending on the purpose of the biopsy and the amount of tissue obtained, the following is carried out:

• histological examination of the material;
• cytological examination of the material.

Histological examination examines tissue sections under a microscope..

To do this, pieces of tissue obtained from a biopsy are placed in a fixing liquid (formalin, ethanol, Bouin's fluid) to compact their structure, and then filled with paraffin. After hardening, they are cut into thin layers with a thickness of 3 micrometers using a microtome (a very sharp cutting tool). The sections are placed on a glass slide, paraffin is removed from them and stained with a special substance. After this, the drug is sent for microscopic examination.

In a cytological study, it is not the tissue that is studied, but the cells.

This type of microscopic examination is considered less precise, but requires less material. In addition, the preparation of a cytological preparation does not require lengthy preparation and special equipment.

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Cytological examination is usually carried out after aspiration biopsy, swabs and smears.. It is used to urgently solve diagnostic problems during surgery (establishing the nature of the tumor process, identifying tumor growth into surrounding tissues and metastases, the presence of tumor cells at the edges of the surgical incision, etc.), as well as when biopsy of a tissue area for histological examination is impossible or undesirable (for example, if melanoma is suspected).

Living cells are visible here - an experienced diagnostician quickly distinguishes leukemic (let's say) leukocytes and other atypical elements.

The significance of this method is great when it is necessary to analyze calcified and bone tissues, loose, crumbling masses and very small foci that are not suitable for histological examination.

When biopsy of tumors, it is most rational to carry out both histological and cytological examination of the biopsy specimen. But the results of histological examination are still decisive for establishing a diagnosis of cancer.

Reliability of biopsy results

The reliability of histological examination exceeds 90%. Its positive result serves as the basis for making a final diagnosis and prescribing a treatment regimen, including surgery for cancer.

If a tumor is suspected, it is better to do a biopsy in specialized government medical institutions, where experienced doctors and experienced pathologists work. This will significantly reduce the likelihood of a diagnostic error. If the result of the histological examination is negative, but the doctor has good reason to believe that the patient still has cancer, repeat biopsies are performed.

Cytological examination is a screening (intermediate) diagnostic method. Its results largely depend on the amount of material and its preservation, as well as on how precisely it is taken. If the result of a cytological examination is positive, then this serves as the basis for a more complex histological examination.

A negative result does not reject the suspected diagnosis of cancer.

What is histological examination?

Histological examination– this is a morphological study of tissues and organs of a sick person, including a biopsy and examination of surgical material. Biopsy– this is a morphological study of pieces of tissue taken from the patient for diagnostic purposes. Study of surgical material is a morphological study of tissues and organs removed from a patient during a surgical operation performed for medicinal purposes. Histological or pathological examination is the most important in the diagnosis of malignant tumors, one of the methods for assessing drug treatment.

What types of biopsies are there?

Biopsies can be external or internal. External biopsies- these are biopsies in which material is taken directly under “eye control”. For example, biopsies of skin and visible mucous membranes. Internal biopsies- these are biopsies in which pieces of tissue for examination are obtained using special methods. Thus, a piece of tissue taken by puncture using a special needle is called needle biopsy taken by aspiration of a piece of tissue is called aspiration biopsies, by trephination of bone tissue - trepanation. Biopsies obtained by excision of a piece by dissecting superficial tissues are called incisional, "open" biopsies. For morphological diagnosis they are also used targeted biopsies, in which tissue is collected under visual control using special optics or under ultrasound control.

Material for biopsy should be taken at the border with unchanged tissue and, if possible, with the underlying tissue. This primarily applies to external biopsies. Do not take pieces for biopsy from areas of necrosis or hemorrhage.

After collection, the biopsy and surgical material must be immediately delivered to the laboratory; if delivery is delayed, it must be immediately recorded. The main fixative is a 10-12% formaldehyde solution or 70% ethyl alcohol, and the volume of the fixative liquid should be at least 20-30 times the volume of the object being fixed. When sending material for pathomorphological examination, most often tumor tissue, lymph nodes, it is necessary to make a smear for cytological examination before fixation.

Depending on the timing of the response, biopsies may be urgent (“express” or “cyto” biopsy), the answer to which is given in 20-25 minutes and planned, the answer to which is given in 5-10 days. Urgent biopsies are performed during surgery in order to resolve the issue of the nature and extent of surgery.

The pathologist, conducting the examination, makes a macroscopic description of the delivered material (size, color, consistency, characteristic changes, etc.), cuts out pieces for histological examination, indicating which histological techniques should be used. Examining the prepared histological preparations, the doctor describes the microscopic changes and conducts a clinical and anatomical analysis of the detected changes, as a result of which he makes a conclusion.

Biopsy results

The conclusion may contain an indicative or final diagnosis, in some cases only a “descriptive” answer. Approximate answer allows you to determine the range of diseases for differential diagnosis. Final diagnosis pathologist is the basis for formulating a clinical diagnosis. "Descriptive" answer, which may occur when there is insufficient material or clinical information, sometimes allows us to make an assumption about the nature of the pathological process. In some cases, when the sent material turns out to be scanty and insufficient for a conclusion, and the pathological process may not have been included in the piece being examined, the pathologist’s conclusion may be "false negative". In cases where the necessary clinical and laboratory information about the patient is missing or is ignored, the pathologist’s answer may be "false positive". In order to avoid “false negative” and “false positive” conclusions, it is necessary, together with a clinician, to conduct a thorough clinical and anatomical analysis of the detected changes with a discussion of the results of the clinical and morphological examination of the patient.

Cost of a biopsy in our medical center

r.d.- working day